Saturday, May 14, 2011

I'm sorry about the way things went at your appointment yesterday. I guess you and I just didn't have great chemistry.

I can understand you being frustrated with me. Obviously, a man of your means is used to people kissing his ass constantly. But here at Grumpy Neurology, it doesn't buy you much. Let's face it, Medicare pays me the same amount to put up with you as it pays me to put up with Mr. Nice Butpoor. If you were paying me $1000/hour to listen to your stories about the yacht club I might be more inclined to do so. But I'm only going to get Medicare's flat $115 for you, and my billing company gets 10% of that, and I have to pay Mary, Annie, my rent, the Diet Coke bill, and my malpractice insurance out of the rest.

Anyway, we were obviously off to a bad start when you told Mary that your regular doctor (who you pay cash to) dresses up for you. And this was before you even had a look at me. You also were not happy that, when you asked Mary what kind of refreshments we offer for waiting patients, she pointed to the water cooler.

I SO enjoyed being grilled over my credentials. I really am a doctor, I swear, not some homeless person who decided to rent an office, hire some staff, and buy some cheap office furniture just for the hell of it. You were clearly not impressed that I went through public schooling most of my life. Of course I've heard of your alma mater, but it was so much more fun to watch the horrified expression on your face when I pretended I hadn't, and then asked you if it was in Arkansas. The devil made me do, what else can I say?

I think we reached the low point during the appointment when, after I'd spent 30 minutes taking your windy history, and another 20 minutes examining you, your heavily plasticized wife (who may be putting arsenic in your prunes- watch out) asked me "So when will the doctor come in to talk to us?" That made me feel real special.

So when I heard you tell Mary that you didn't want to schedule a follow-up with me, and wanted to discuss matters with your internist, I knew this translated to "I'm never coming back here and am complaining to my internist about you". And guess what? I don't care.

Be careful the automatic door doesn't hit... oh, sorry, guess I should have warned you sooner.

you named him correctly. what a jerk. i think you are better with him not being a patient of yours.don't say the "devil made me do it". i think it was your wonderful sense of humor, which he didn't get (some things money can't buy)and i've been at many a doctors offices over my life span and more doctors DO NOT have refreshments. the fact that you offer water is great.at my primary care physician's office ... on friday he wears jeans and actually has a nice butt for us to look at :)that guy needs a life ... i don't care what my doctor is wearing ... i've seen scrubs, jogging suits, $1,000 suits, jeans, t-shirts ...

Credentials? Thought you were a "Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks!"

Truly, WTF is wrong with people? I do my research before I go see a medical profession (are they board certified in ????. etc.,) and I don't quite give a Mongolian's Yak where one goes to school. From what I hear, "The one that graduates at the bottom of their class is called, MD!"

However, I like a Dr. who after asks me 90 minutes of questions and exams me from head to toe if I have any questions about my conditions, his findings or about him? But I don't expect that! I do think patients have right to know about whom is treating them, but it's also our responsibility as a patient to do our research.

So, did ever come back or complain about you?

PS. I know you don't answer Medical Questions but (and if you can't I understand) do you know if any new migraine preventatives coming down the pipeline? Thanks.

You know, when I go into a medical professional's office, and they have all kinds of fancy treats, and the office is super-fancy with lots of random staff, and the doctor is all dressed up, my reaction is to grab firmly onto my wallet and to prepare myself to say no to a bunch of unnecessary treatments. Honestly, how do people think doctors can afford all that crap?

Yep, I remember patients like this. You're lucky that you practice for yourself. For those of us in academics or hospital-owned practice, this sort of incident usually leads to a meeting with the department head who gives you a slap on the wrist and asks you to attend sensitivity training.

@Anonymous above - my physician suggested taking riboflavin (vitamin B2) supplements for migraine prophylaxis, and I really think it has made a difference for me in terms of migraine frequency. It's available OTC for about four bucks at a supplement store like GNC. Obviously check with your own doctor first, as I have no idea what you are already taking and also am not a doctor. Anyway, here's a link to an abstract of a big study that found this benefit: http://www.ncbi.nlm.nih.gov/pubmed/15257686.

"Refreshments?" At the neurologists office? Really, dood? I must be one of the unwashed masses as I bring my own water bottle most places. The kids' orthodontist has coffee and tea, but I really think that's the exception.

WTF? Refreshments? What planet is this guy from? Most places of business can give you a glass of water. Otherwise, BYO.As far as credentials go, in this age of specialisation, and plethoration of qualifications, associations, memberships, residencies etc, etc. how do you even know what questions to ask? There's a reason you ask your internist, PCP or specialist for a recommendation, instead of throwing a dart at the AMA register. If you can't trust their judgement about the competence and qualifications of the professionals they refer to, you should be asking around for recommendations for a new doctor.

I suppose at a neurologist that's less of a concern, but - remembering the clientele of your GP - would you really want to touch refreshments that have been touched by the other patrons of your family doctor?

On a first date 20 years ago, a certain smart-ass and I were comparing where we lived, went to school. When I proudly said, "Cornell," he asked, "Is that in the Ivy League?" I married the SOB and am still getting his sweet grief that makes me laugh at myself, every day of my life.

some interesting posts up there. but it will get worse because cms will decide the portion of that pittance providers are to receive based on popularity surveys of customer satisfaction. the fact that we provide advice and intervention to those in real need is lost in the fluff.

Obviously he needs to pay cash and lots of it if he expects a neurologist to dress up for him! Geez Louise! And refreshments? Seriously, refreshments? 99% of the physician offices I'm in don't have anything besides water and a number of them don't even have that.

"So when will the doctor come in to talk to us?"

The Teenage Mutant Ninja Kitty Horde is hunting down the heavily plasticized wife as we speak.

Only time I’ve seen refreshments and snacks (or knew they were available even if not visible) were at the cancer center or in the pre-surgery testing area -- right by the blood letting chair. Of course this all means 1. you have a small window couple of times a day when you can eat small bits of food your body probably won’t upchuck, or 2. You’ve been fasting for the past twelve hours and those dry muffins and burnt coffee looks mighty tasty...

If you want all kinds of fancy attached to medical service, and you are a rich gluteal foramen, why didn’t he go find a concierge neurologist? (Oh, wait maybe there is no really good concierge neurologist...)

Kinda reminds me of the time I had a person come in and "interview" me to see if I was good enough to be his pharmacy. "Do you deliver"....no"Do you have an on call pharmacist"....GOD no..and on and on...Apparently we didn't make the grade.WHEW!!

Some of your readers obviously do not know how Medicare works. Medicare COSTS MONEY to be enrolled in, which is taken out of your SSI or SSDI, if you're like me. If you're rich and have boatloads of money, they take a lot more money out than for us poor people.

It's still not the same as regular insurance, but it's not some free tax-money ride that the masses believe Medicare is.

Medicare may cost some money, but it is no where near enough to actually cover the full cost. In the pharmacy world, Medicare recipients are expected to cover some of the cost through premiums and co-pays, but it is only a fraction of the true cost of the medications. The tax dollars of the working masses covers the rest.

I have had patients like that. And as a nurse I don't get to fire them. A few years ago they opened up a posh new hospital on the "good side" of town and all the nurses ran over there to apply. I found out that part of their interview process was a "personality" test to see if you would be compatible serving their "clientel". No, I am not - thank you very much.

Didn't you have one of those partly-eaten bagels from the hospital cafeteria that you could have given him?

I only once went to a specialist (recommended by a friend)...and the office was beautiful- suites with so many plants in the courtyards that it was like going to an indoor rain forest exhibit. I cannot remember if there were refreshments, but there was an extraordinary selection of the best magazines and tons of really great free samples. If I had any other condition, I would be back there right away because it was down right fun to go to that office. In fact, when we were driving by, I took a friend in to see the courtyards- fantastic. And the doctor was OK too. And she did have designer clothing- It was mostly covered by a white coat, but the tiny bit sticking out of the hemn was very pretty. So, I dunno...maybe you should have offered the guy a diet coke...or you should get a keurig...there is free coffee at my auto mechanic's and I like it. But the patient should not have insulted you because you might not try 110% to cure him. :(

I had the misfortune of treating his sister, Mrs Entitled Beeyoch who bitched at me for not having herbal tea for her at 0200. Want herbal tea at 0200? Pay more taxes or better yet, go to your mansion and play hide and go eff yourself! Yes, just a tad bitter today :p

So glad to see your diet coke bill comes ahead of your malpractice insurance. That is the best advert for potential patients to line up outside your surgery door; not that they need any encouragement if they read your blog.Hail to Dr. Grumps!

Welcome to my whining!

This blog is entirely for entertainment purposes. All posts about patients may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate.

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Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.